中文版明尼苏达心衰生活质量量表的维度分析

目的 基于经典测量理论与项目反应理论完善中文版明尼苏达心衰生活质量量表(MLHFQ)的维度划分与评价。方法 于2019年3月—2020年6月在天津市4所三甲医院便利选取487名心力衰竭住院患者进行中文版MLHFQ测试，使用经典测量理论中的探索性因子分析与验证性因子分析确定MLHFQ因子结构，使用项目反应理论中的Mokken量表分析评价因子结构。结果 探索性因子分析提取躯体症状、日常活动、医疗负担和心理负担共4个因子，累计方差贡献率74.707%。验证性因子分析经MI修正后模型整体拟合度良好(χ²/v=3.325,RMSEA=0.097,CFI=0.928,IFI=0.928,TLI=0.914)，量表聚合效度良好(AVE范围0.592～0.799,CR范围0.806～0.958)，其中躯体症状和心理负担维度区分效度较弱。Mokken量表分析显示总量表一维性良好(Hi>0.3,H>0.5)，四个维度均具有高度一维性(Subscale-Hi>0.5,Subscale-H>0.5)。信度指标Cronbachα、λ₂、MS均大...

Dimensional analysis of the Chinese version of Minnesota Living with Heart Failure Questionnaire

Objective To explore and evaluate the dimensions of the Chinese version of Minnesota Living with Heart Failure Questionnaire (MLHFQ) based on Classical Test Theory and Item Response Theory. Methods From March 2019 to June 2020, 487 patients with heart failure were selected for the Chinese MLHFQ test by convenience sampling method in four tertiary hospitals in Tianjin. The factor structure of MLHFQ was summarized using exploratory factor analysis and confirmatory factor analysis in Classical Test Theory and evaluated using Mokken scale analysis in Item Response Theory. Results Exploratory factor analysis extracted four common factors, including physical symptoms, daily living activities, medical burden, and psychological burden, with a cumulative variance contribution rate of 74.707%. After the MI index was modified, the confirmatory factor analysis showed that the overall fit of the model was good (χ2/df=3.325, RMSEA=0.097, CFI=0.928, IFI=0.928, and TLI=0.914), the aggregation validity of the scale was good (AVE=0.592-0.799, CR=0.806-0.958), and only the physical symptoms and psychological burden had weak discrimination validity. Mokken scale analysis showed that the total scale had good unidimensionality (Hi＞0.3, H＞0.5), and the four dimensions had strong unidimensionality (Subscale-Hi＞0.5, Subscale-H＞0.5). Reliability indicators Cronbach’s α, λ2, and MS were all greater than 0.7. Conclusion The Chinese version of MLHFQ has four dimensions, including physical symptoms, daily living activities, medical burden, and psychological burden. The quality of life of Chinese patients with heart failure will be more comprehensively evaluated by using the MLHFQ total scale and the scores of the four-dimensional subscale.